Nutritional Guide for Multiple Birth Pregnancy

Food Group
Milk and milk products
Breads and cereals
Fruits and vegetables
Meat, fish, poultry and alternatives
Number of Daily Servings

Please refer to Canada’s Food Guide for information on portion sizes.

Use in moderation: Fats and oils (example: butter, margarine, salad oils)

This nutritional guide will provide you with about 2000-2600 calories. It meets the nutrient needs for the second and third trimesters of the average, healthy woman expecting twins or triplets. The foods listed here are to guide you only, as the needs of each individual will vary. If this is not enough food for you, more servings can be selected from the food groups. Small, frequent meals, with snacks, may help you eat the larger volume of food and aid with the control of heartburn.

Following are some sample Menus which incorporate foods from the Canada Food Guide for a Multiple Pregnancy.

1/2 grapefruit
Shreddies and Milk
Whole wheat toast with margarine
Tomato meat sauce
Grated cheese
Steamed zucchini or broccoli
Milk pudding
Baked beans or chicken leg & bread, margarine
Spinach and Tomato Salad with salad dressing
Bran muffin
Cheese and crackers
Hard boiled egg
Fresh fruit

Adequate fluids are important and 6-8 glasses of fluids per day are recommended. Alcohol should be avoided and caffeine consumed in moderation (e.g. coffee, tea, chocolate, soft drinks)

You will need an iron and folic acid supplement for your multiple pregnancy and these are prescribed by your doctor. Your doctor, dietician or nutritionist can advise if there is a need for further vitamin supplementation and if so, which ones.

Salt (sodium) should not be restricted. Moderate amounts may be used at the table or in cooking.


Studies have shown that women who gain 26-35 pounds (16-21 kg) with their twin pregnancies, have healthier babies. The weight gain pattern for twins and a singleton in the first trimester is the same. You can expect to gain 1-4 pounds (0.05-2kg). In the second and third trimesters, you can expect to gain about 1.5 lbs. Per week (0.75kg). By 24 weeks gestation, you will likely have gained 24 pounds and by 32-36 weeks, 32-40 pounds.

REMINDER: All weights noted are suggested amounts recommended for the average, healthy woman.

Triplets and Quadruplets: A suggested weight gain for a triplet or quadruplet pregnancy has not been documented. However, one could deduce that a triplet suggested weight gain should slightly exceed that of a twin pregnancy, while a quadruplet weight gain be slightly more than the triplet pregnancy.

NOTE: When weight gain is too low, it could negatively affect the outcome of a pregnancy. Low weight gain affects the hormonal response to the pregnancy and therefore limits intrauterine growth. It is recommended that if any point in your multiple pregnancy you should feel that you are unable to eat one of the good groups, or are not sure whether you are eating properly, whether you have sufficient vitamin supplements or are unable to gain the recommended weight, ask your doctor for a referral to a dietitian.

Adapted and Compiled From:
Canada Food Guide

Nutritional Guidelines for a Multiple Pregnancy, by Pauline Brazeau-Gravelle and Julia Watson-Blasioli, printed by the Ottawa General Hospital; May, 1997

Calgary Foothills Hospital, Clinical Nutrition Services.

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